HomeMy WebLinkAboutPermit Electrical 1992-05-15225 FIFTH STREEf,
SPRTNGFTBIJ, ORBGoN 97
INSPECTION REQUEST: 7
OFPICE: 726-3759
t
tl oL?>t ob o'tq Da
use
ELBCTRICAL PERHIT APPLICATION
City Job Number
SCEEDULB BBLOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular DveIling
Service or Feeder
s 8s.00
$ 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations or
Relocat ion:
200 amps or less / q,
201 amps to 400 amps _
401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts _
Reconnect 0nly
c Temporary Services or'Feeders
Installation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circui t s 3s.00
Each Addi tional
Circuit or vith Service
or Feeder Permi r 2 $
9?:'a-'W 3
'iilcrizod
st'rrrNGl=rGL(,
5. SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
PnrPa4
)
0h
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation S
Sign/outline Lighting- $
Limi ted Energy/Res $
Limited Energy/Comm $
LOCATION OT
35'.7 U.&37:A
I,EGAL DESCRIPTION
Sum
JOB DBSCRIPTIONl-u.otrz zEs* Trtert 9oo AMP
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2.. COMRASTOR INSTALI..ATION ONLI
Electrical Contractor /"uo
Addressf gctdD '{Ylrr.rt *LO- LA
Ci ty
Supervisor License Number 37 C.2
Expiration Date l0 - I - 1 7-
Constr Contr. Number 3 >Lbo
Expiration Date' 4-u-7>
Signatu of Supervisi Electrician
200 amps or less $ 40.00
0ver 401 to 600 amps _ $ 80.00
0ver 600 amps or L000 volts see rrBil above
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
5a.4
=
')
2
Owners
Address
Ci ty t)Phone
OIJNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
fv.-
2.oo !z?
E not included)
40.00
40.00
20. o0
DATE:
RECEI PT -75
J-
KPP,
OREGO'U
RECEIVED BY:
t*ttagat&A2 o
?
(ry;y f- r;roolt
fi{\) pnone'72)c,-%t/
SPR-CITY ECOrV
225 FIFTB SISBET
SPRTNGFIBTD, ORBGoN 97477
INSPBCf,ION RBQUEST: 726-3Tb* --.
OFFICE: 726-3759 .i
Sr']IINGFIGLo
SU
nd dd,e!. not require specilic land uso
A
B. Services or Feeders
Installation, Alterations or
1r- Relocation:
EI.,BCTRICAL PBRHIT APPLICATION
City Job Number
BELOV
New Residential-Single or
Multi-Family per dvelllng unit.
Service Included:
Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
5fi3>
1
1
Permits are non-transferable and expirelf vork ls not started vlthln 180 days
of issuance or if vork is suspended for
180 days.
2. CONIRAGTOR INSTALI,ATION ONLY
Electrical Contractor
Address
Ci ty Sp-AliL Phone C Q-' clll
---':-1.,,
Supervisor License Number
Exp iration Date , '. r .'
Constr Contr. Number
Expiration Date 7-gz
ture of Supervlslng Electrlclan
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to L000 amps_
0ver 1000 amps/volts
Reconnect 0n1y
Sum
?P
$ s0.00
$ 60.00
$100.00
'vgG *s $130.00
$3o0.oo
$ 40.00
$ 3s.oo - ox
C. Temporary Services or Feeders
Installatlon, Alteratlon or Relocation
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
0ver 600 amps or 1000 volts see rrBrr above
Name
Address
ci Phone
OIINER INSTALI,ATION
The installatlon is being made on
property I own which is not intended
for sale, lease or rent.
Onners Signature:
DATE:
RBCEIPT
D. Branch Circuits
Nev, Alteratlon or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permi t $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _ $
Sign/OutIine Lighting_ $
l,imi ted Energy/Re"
-
$
Limited Energy/Comm 1 $
40.00
40.00
20.00
36.00
5. STIBTOTAL OT ABOVB
5Z State Surcharge
TOTAL
RECEIVED BY
OO
CITY OF SPRINGFIELD
Development Sr:rvlces
225 North Sth Street{?t^t1)
Job No. i'J()A r -1
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JOB ADDRESS\
Date 4
TO:
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CONIX RESEARCH
857 NORTH ?STH STREET
SPRINGEIELn, 0REfi0N 97477
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170?310001400 9?0507 / 9?05fi7
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